Dr. Zainab Okolo of The JED Foundation: Building the Workforce and Systems Needed to Support Youth Mental Health

Van Ton-Quinlivan
Hello, I’m Van Ton-Quinlivan with Futuro Health, welcoming you to WorkforceRx, an ongoing conversation with leaders and innovators offering insights into creating a future-ready workforce.

One in four young people in the U.S. experience a mental health condition or illness, but the majority will not receive the help they need. While there are various factors that contribute to this unfortunate reality, a shortage of trained child and adolescent mental health professionals is a leading cause.

We’re here to explore the state of youth mental health and the workforce and resources that this population needs with our guest, Dr. Zaina Okolo, a trauma-informed licensed mental health clinician with a doctorate in education from George Washington University.

Dr. Okolo is Senior Vice President of Policy Advocacy and Government Relations at the JED Foundation, a nonprofit that protects emotional health and prevents suicide for teens and young adults. As part of fulfilling that mission, JED generates research that informs policy and practice in schools and communities nationwide.

Thanks very much for joining us today, Dr. Okolo.

Dr. Zainab Okolo, LCMFT
Thank you so much for having me, Van. It’s great to be here with you.

Van Ton-Quinlivan
So, what would you like to add to the brief description that I gave on the scale of the mental health problem with youth in the US?

Dr. Zainab Okolo, LCMFT
So one thing I would add immediately is that the scale of this challenge is not simply about the number of young people experiencing anxiety, depression, or suicide ideation. It is also about whether the systems surrounding them are prepared to recognize distress early and respond effectively.

In 2003, 20% of high school students reported seriously considering suicide, while 9% reported attempting during the previous year, and suicide was also the second leading cause of death for young people ages 10 to 24. So this is something we’ve been grappling with for a while, of course, exacerbated by the pandemic, but the burden is not evenly distributed. Young people’s experiences are shaped by geography, race, economic stability, family support, access to insurance, and whether there is a trusted adult or qualified provider available when they need help.
This is why we cannot treat youth mental health as an individual failure or expect the clinical workforce to solve it independently. We need a public health approach that strengthens families and schools and colleges, communities, healthcare systems and other networks, and especially the policies that determine whether young people have access to support before they reach crisis.

So that’s a bit of a lens that myself and us at the JED Foundation take a look at when we’re considering how we need to take on the youth mental health crisis.

Van Ton-Quinlivan
Most of us are aware that there has been an increase in mental health and behavioral health issues for our young people, but maybe you could just dive in for a moment and give us what is happening in this moment in time that is different from maybe a decade ago or two decades ago?

Dr. Zainab Okolo, LCMFT
Yeah, so I’ll go ahead and just capture the last decade to kind of outline what I just shared. The pandemic was really a clarion call for those of us that work in in mental health, both as practitioners and advocates. I happen to be both. So as a licensed clinician, trauma-informed, I’ve worked with families and youth as they have processed traumatic experiences. And being a provider, I have worked to ensure that my practice made mental health accessible and impactful for these families.

But what we’re seeing over just the last decade, again intersecting the impacts of the pandemic, is a greater demand for such services. A lot of the work that had been done from advocacy circles around destigmatizing conversations around mental health and suicide were actually successful. It has increased the demand from population for readied, experienced, licensed clinicians to meet the need. And so when we saw that that spike in that data from the CDC of 10 to 24 year olds having ideations, to it leading to the second leading cause of death being suicide, we’ve really had never seen data like that before. So that was unique.

Now, over the last couple of years and leading into this year, we’ve seen the trend go in the right direction. So we’re seeing actually a decrease for the first time in six years of suicide completions for our youth populations, that population that I just mentioned. However, the demand is still high and the reports from youth of depression, anxiety, suicide ideation are still too high. And of course, our work and the work across the ecosystem is to bring suicide to zero, so there’s still a lot of work to be done, a lot more to offer to student populations and to make available to greater populations around mental health and suicide prevention resources.

Van Ton-Quinlivan
So you talked about shortages in clinicians. For the listeners who may not be fully aware, there’s really a preventive workforce and then there’s a treatment workforce. I wonder if you could just lay out the training levels and then where are we having the shortages and what is your recommendation?

Dr. Zainab Okolo, LCMFT
So the challenge is both a shortage and distribution problem. Providers have not always been located where the greatest need has been and not every provider is trained to work with children and adolescents and young adults. So it’s a “both-and” conversation now. And these shortages are especially acute for rural communities, tribal communities, lower income areas, and communities that need culturally responsive care. We also have significant gaps in child and adolescent psychiatry, psychology, school counseling, marriage and family therapists, substance treatment, and community-based care.

We know that those training models oftentimes take two, three, four years. So it’s not exactly a quick pathway like a certificate would be. So HRSA projects that by 2038, the country could face shortages of approximately 100,000 mental health counselors and nearly another 100,000 psychologists. And these projections are based largely on current service utilization that becomes even more severe when existing needs are included.

We should also remember that availability on paper does not necessarily mean accessibility, and this goes into some of the conversations around insurance and folks being able to connect to the appropriate provider. So for a young person who may technically have a provider nearby, they may still face a six-month wait, inadequate insurance coverage, transportation barriers, or difficulty finding someone who understands their identity or developmental stage.

A lot of this, Van, has also led us into having the conversation of how do you connect folks with the right provider, right? I’m going to a different practitioner for a cold than I would if I might be struggling with a more serious health diagnosis and so it should be mental health.

So these are some of the ways that the workforce is finding gaps and we really have to think about how to fill those gaps as quickly as possible because the demand is not stopping.

Van Ton-Quinlivan
You had previously mentioned the rural areas, the tribal areas, low income areas and then cultural providers who are culturally responsive. So in the in the parlance of workforce development, part of the work is you have to grow those practitioners from those populations so that they want to serve those populations. Are you seeing any effective practices or any effective policies that beget that talent pool?

Dr. Zainab Okolo, LCMFT
Absolutely, but I do believe there has to be more and it has to be more intentional and more targeted. So that was a very big question, Van, in that we’re asking not only about workforce, now we’re asking about credentialing: which credentials are valued, and how folks are able to get on those pathways. So the principle should be to extend the reach of licensed professionals without lowering the quality or safety of care. And it’s really important for us to think about from interest to entry to completion how to make access to accredited valid programs available to as many folks that are interested in working in the space.

I’m saying that very carefully because as mental health has grown in popularity as a topic, what has happened has been an increase of certificates. Some are very helpful. Some are being utilized to really close the gap. And others don’t equip practitioners with enough to actually do the work that a clientele might need.

I’ll also say, being a clinician myself, being culturally responsive does not require me to come from the culture I hope to serve, right? I was taught to kind of be able to study the gamut and be able to identify some separate identity markers and challenges from, let’s say, indigenous communities, that might separately impact black and brown communities. And that’s just the work and the ethos of a practitioner.

So that’s another layer of why it’s so important to ensure that these accrediting bodies are available and these pathways are clear so that folks can have as many options as possible when they do finally seek out care.

Van Ton-Quinlivan
So the career path to getting the credentials and the license to be a therapist is at the master’s level, right? And psychologists, psychiatrists, my goodness, that’s more advanced. It’s a very long route to build and grow those talents, so in the in the meantime, what are your thoughts on emerging roles, credentials, and care models that could help extend the reach of the limited licensed workforce?

Dr. Zainab Okolo, LCMFT
So in connection with your last very timely question, the principle should be to extend the reach of licensed professionals without lowering the quality of care. And so peer support specialists, youth peer navigators, community health workers, recovery coaches, care coordinators, behavioral health technology technicians all play an integral and a very important role in outreach and prevention and navigating and skill building and ongoing support in what I consider a high touch capacity.

Because even from a therapeutic standpoint, I might see clients once every other week or once a week, and then depending on where clients are in their journeys, they might need somebody that’s more let’s say like a behavioral health technician or a coach to be more high touch depending on what their challenge or growth opportunity is.

So for these roles, they can also create pathways into behavioral health careers for young people from communities that have been historically underrepresented in the profession. And so some of those community based, community aware roles are very, very important and very significant to the growth and the expanse of the workforce. And we should also expand into integrated care models, meaning pediatricians, primary care providers, school nurses, educators, campus staff are oftentimes the first people to be able to notice if something is wrong. I mean, you and I can remember Van, it wasn’t every time that you went to your yearly physical that your primary care provider asked you, “Are you feeling okay? Are you depressed?” Now that’s a staple part of the integrated care model is for the first touch access folks within a system that might not be a licensed clinician or psychologist — but that have access to you within a context — to take the time to ask, do you need some additional support? And then being able to refer you out to folks within your network that are already covered by your same insurance is extremely helpful. And program programs such as

HRSA’s Pediatric Mental Health Care Access Program helps pediatric professionals consult with behavioral health specialists and incorporate mental health into care routines, which is really important. And then of course, we can’t forget about pieces like telehealth, collaborative care, group interventions, and school community partnerships are also able to increase reach.

The important distinction here is that these models should create pathways to appropriate human care, not leave peers and educators and tech platforms managing all clinical risk that are beyond their training and their actual built function.

Van Ton-Quinlivan
Tell us more about what the JED Foundation does in order to support young people and their mental health struggles. And I’m also wondering if the listeners are on the PTA or the school council, how do they tap into JED resources to improve the ability of the school environment and everybody who’s in the school environment to detect and support young people with their struggles?

Dr. Zainab Okolo, LCMFT
So the Jed Foundation protects emotional health and works to prevent the suicide of teens and young adults. What distinguishes JED is that we do not focus only on what happens after a young person enters the counseling office. We focus on strengthening the entire environment or system surrounding that young person. JED partners with high schools, colleges, school districts and youth serving organizations to assess their systems, identify gaps, and implement comprehensive data-informed strategies.

We also equip young people with the knowledge and skills to help themselves and one another reduce stigma, encourage help seeking, and advocate for public policies that create safer and more supportive environments. And our comprehensive approach is the guide that we use to ensure that we do this work consistently and with as much fidelity as possible.

Those seven areas include developing life skills; promoting connectedness and a positive culture; recognizing and responding to distress; reducing barriers to help seeking; ensuring access to effective care; establishing strong crisis management systems; and reducing access to lethal means.

The underlying idea is that suicide prevention cannot rest on one program or one training or one counseling center and it is definitely not the responsibility of just one office on a student’s campus. Young people need a coordinated safety net that promotes well-being, that identifies concerns early, and that responds effectively when someone is in distress. That starts with messaging from the top down, right?

So at any point on one of our JED campuses, that campus is effectively trained to not only look for distress or look for crisis, but to create an environment whereby mental health is prioritized and is considered a key marker in student success. So, we’re really proud of that which we’ve been doing for about 27 years. We have over 500 campuses that are JED campuses and it continues to expand the environment by which mental health becomes commonplace for youth as they seek out services.

Van Ton-Quinlivan
What’s the first step in becoming a JED Campus?

Dr. Zainab Okolo, LCMFT
Reach out! so on our website, www.jedfoundation.org, there is an information link there, and we’re happy to send information and have conversations with any institutions or systems that would like to be a part of our network.

Van Ton-Quinlivan
You’ve been working downstream with college campuses, so tell us more about what a good mental health support program looks like in that setting. It’s also one of those tricky things where an individual, when they turn eighteen, the information between what the college sees and what the parents can sees is…there’s a becomes a wall, right? So I wonder what you’re doing at the college level right now.

Dr. Zainab Okolo, LCMFT
That’s right. So to answer your question about what does a good college mental health support program look like, it’s not simply about, again, a well-staffed counseling center. The counseling center is of course essential, but it is not the only part of a comprehensive campus system. A strong approach begins with senior leadership, making student mental health a strategic institutional priority and using data to understand who is struggling, who is accessing care, who is not, and exactly why. Is the barrier around stigma? Is it around access? Is it because they don’t understand how insurance works? It is then leadership’s role and job to help close that gap.

A system should include prevention and life skills education, opportunities for belonging and connected c connectedness, faculty and staff and student training. Because what we’re also finding as we serve institutions and close gap gaps for students, that faculty oftentimes are looking for the same supports and need the same transparency and training on how to receive services at all. Also clear pathways for referring someone in distress, accessible and cultural culturally responsive clinical care. After hours and crisis support that includes prevention procedures and substance use prevention. And we can’t talk about that without highlighting lethal means safety. It must also address barriers such as cost and transportation, disability access and stigma, and food and housing insecurity, and fear about confidentiality.

A lot of this work and a lot of the programming is meant to highlight that mental health is a basic need. So we look at food, shelter, water as a basic need. Mental health, wellness, behavioral health, and psychological safety are also basic needs. And most importantly, students should not have to understand a university’s or institution’s organizational chart just to receive help, whether they disclose a concern to a professor, a residential life employee, a coach, an advisor…there should be a coordinated pathway for connecting them to the appropriate supports. So that means that the systems have to take responsibility for making that training available.

That is the difference between offering individual services and shelving all of the responsibility to get connected to those services on the user, on the student, on the client and ensuring that we build out campus wide cultures of care. JED’s model brings these components together across the seven domains that I mentioned.

Van Ton-Quinlivan
As you gave us all the details on all the dimensions that need attention, I really appreciate the layout of the systems approach to creating this culture of care. So, thank you.

Of course, Zainab, I have to ask you the AI question. You’ve been doing some research on how teens are using AI and what it means to their mental health. What are you finding so far?

Dr. Zainab Okolo, LCMFT
So we know that AI is here, and it is now an integrated part of youth and their daily lives — how they communicate, how they learn, how they process information. And remember that we are now serving a population of digital natives, meaning they don’t know a world without Wi-Fi, so embracing AI, might feel like second nature to them because it is and the technology is moving at a rapid pace.

So, we have two related bodies of research that help illuminate this issue. First, JED collected information from more than 5,000 middle school and high school students across 21 schools and districts. Our initial findings show that AI use is already deeply embedded in youth lives, where four in five students reported using some form of AI on a daily basis. More than half use it for academic purposes. Nearly one-third use it for relationship and problem-solving advice. More than one in ten use it for companionship. And nearly three in five reported using AI when they felt sad, stressed, or lonely.

Separately, nationally representative research conducted by Surgo Health, one of our partners, found that 12% of young people reporting mental health struggles, use generative AI for mental health support. Those who turned to AI often reported barriers of professional care, cost, limited caregiver support, privacy concerns, or not knowing where help was available, so they turned to the AI that was on their phones.

The important takeaway is not that every use of AI is harmful, and I actually think the context or the confine of “AI good” or “AI bad” is very limiting right now. The concern really is for a well-supported young person, AI should be a tool, but for someone who feels isolated or cannot access care, it may become a substitute for human connection or even professional support and those are very different risk profiles.

These findings are not finalized and do not establish that AI causes mental health challenges, however, they do tell us that young people are already using these systems for emotionally significant purposes, often faster than, of course, adults from different generations, institutions, and policymakers have developed appropriate guidance for.

Policy does not move at the same pace of technological development and that’s something that is what we’re also grappling with. Policy relies on things like use cases, then research, then legislation, then votes, then passing bills. While all this is happening, the same version that we walked into 2026 with of any of your favorite AI platforms have evolved and the year is not over. So there’s a there’s a lot of work to be done there, and a couple of gaps to be filled, but what we do know is that youth are turning to AI more consistently.

Van Ton-Quinlivan
So where does that leave you in terms of advocacy? What are your main goals right now in terms of federal and state policy?

Dr. Zainab Okolo, LCMFT
Yes. So one thing that we are looking to ensure is to make sure that when youth in particular turn to AI platforms for mental health or let’s say they’re really struggling with depression or anxiety, that these platforms are able to encourage them — once it ascertains the line of questioning that’s being engaged — to valid outside resources. So that would include resources like Crisis Textline or 988, or even the JED Foundation, because we have quite a few resources online. I could also name organizations like the American Foundation for Suicide Prevention, or the National Alliance for Mental Illness.

Encouraging these platforms and training these platforms to recognize when a user is seeking out information to enact harm on themselves or others and then triggering appropriate responses to get them off the platform and to help, I think is very important. But that would take an act of legislation. That, for example, is a policy correction for the models that we’re using every single day and we can’t get to it faster.
What we’ve done recently is we hosted a Capitol Hill briefing in partnership with Dr. Stephanie Haridopolos, our current interim Surgeon General, highlighting some learnings from our data and also from the most harmful uses or impacts of screen use report that HHS published highlighting some of the guidelines around what we’re hoping to see in AI platforms, ways in which we can make it safer, and ways in which those platforms can be embedded to answer those calls appropriately and direct folks to in-person care off the platforms, especially when they are in distress.

Van Ton-Quinlivan
What a great idea to advocate for guardrails in the use of those platforms.

It was announced earlier this year that JED is merging with the American Foundation for Suicide Prevention, creating the nation’s largest lifespan focused suicide prevention non- profit. Tell us more about this partnership.

Dr. Zainab Okolo, LCMFT
Yes, so very exciting. The announced merger is a merger of equals and as currently planned remains subject to, of course, regulatory approvals, with completion expected by the end of this year. But the two organizations bring highly complementary strengths. AFSP has an extraordinary national chapter network, a deep investment in suicide prevention research, strong advocacy capacity, community education, and support for people affected by suicide laws. JED continues to bring extensive expertise in teens, young adults, education systems, comprehensive prevention models, cultural change, and the environments in which young people live, learn, and grow.

So together, the combined organizations have the potential to create a truly lifespan-focused suicide prevention strategy from strengthening protective factors and connectedness early in life to identifying and treating risk, supporting families and communities, advancing research and helping people heal after loss.

What excites me personally most about this connection is that the national research and policy with local implementation focus can be at greater scale. We can potentially move evidence into communities more quickly, given AFSP’s state and local level chapters, and create stronger continuity across different stages of life and speak with an even more influential, unified voice about the investments required to prevent suicide.

The organizations have been clear that the goal is not simply to become larger, it is to combine complementary capabilities in a way that saves more lives and produces measurable population-level impact. So this is couldn’t have come at a better time. This is extremely exciting and we’re really looking forward to the impact of the work that the merger will produce.

Van Ton-Quinlivan
Well, congratulations and I’m glad that this podcast is going to bring awareness to the good works of JED Foundation as well as your new partner here.

Dr. Zainab Okolo, LCMFT
Thank you.

Van Ton-Quinlivan
Before we go on to our last question, Zainab, I wanted to just ask you, we know that suicide remains the second leading cause of death between ages of ten and fourteen. Is there anything else we need to know or could benefit from knowing?

Dr. Zainab Okolo, LCMFT
I think what’s important to know is that suicide is indeed preventable, and that’s important to say. It might be obvious to us on this call, but in the conversations around mental health and suicide prevention when it was a highly, highly stigmatized topic, it made it seem as though, number one, it only affected a certain type of person or only certain people with certain struggles were affected. The deeper I’ve gotten into the research and the work, you’d be surprised how many of us, if not personal personally, within our families have been affected, or within our very close networks, know someone that has struggled with their behavioral health, mental health, and suicide prevention.

With that comes the notion that it’s unavoidable and we also want to debunk that. There are strategies towards creating environments and systems by which there is hope, where there’s access to care, and then trauma doesn’t have the final say or verdict on somebody’s outcomes. It includes strengthening economic security, housing stability, connectedness, closing the gap, because we know that we’ve been going through a loneliness epidemic for a while, coping in problem solving and ensuring that we reduce access to lethal means and increase access to crisis care and mental health resources when necessary.

The evidence tells us that no single intervention is particularly sufficient, but prevention requires coordinated action at the individual, family, institutional, community, and policy level. So this is all of our responsibility and work and there’s real ways for us to connect the dots to ensure that everyone has the resources that they need to have the best state of mental health possible.

Van Ton-Quinlivan
Well, I know I feel more optimistic now that I’ve had time with you to better understand all the work that is being done in order to advocate for our youth and the mental health needs of all of us. I wonder what makes you optimistic about youth mental health looking into the future?

Dr. Zainab Okolo, LCMFT
Thank you for that question, Van, because I like to say I’m a big Gen Z fan — and that’s a big deal coming from an elder millennial. Young people make me optimistic. They are speaking about mental health with a level of clarity, of courage, of sophistication that previous generations were not encouraged to demonstrate at all, and they’re challenging stigma. They’re supporting their peers, they’re contributing to the research, they’re asking policymakers the right questions, and they’re demanding that institutions do better.

At the JED Foundation, we host a program known as the Youth Advocacy Coalition where we train these youth that have interest in becoming policy advocates around this topic every single year. And every year, each cohort comes with a more unique and dynamic story of lived experience and a louder voice on what they want the world to look like in service to them and their peers as it relates to behavioral health.

I couldn’t be more proud or inspired by our young people and our next generation. I’m also encouraged that more leaders are recognizing that mental health is foundational and not separate from education or workforce development or physical health or public safety or economic mobility. So platforms like your own, Van, taking the time to intersect this conversation and the workforce conversation, I think is powerful. I’m excited to see more leaders like yourself take the time to share their story and share why mental health is so important at this hour.

We’re also seeing colleges build comprehensive strategies rather than rely solely on counseling centers. By the time COVID hit, counseling centers had eight month-long wait lists, so that couldn’t be the answer. We couldn’t just send our students back into systems without having a statewide, nationwide conversation around access models and school-based services, and we didn’t shy away from the opportunity.

Even within the AI conversation, I’m also optimistic because young people and researchers and mental health experts and policymakers are beginning to ask the harder questions about responsible innovation and what it needs to require. So my optimism does not come from believing that the challenge can automatically resolve itself, but it comes from seeing that solutions exist and that when we align policy and workforce institutions and communities, and of course youth voice, meaningful progress is indeed possible.

So that’s where I get my joy and my push through this work from.

Van Ton-Quinlivan
Hear, hear. Thank you very much, Zainab, for being with us today. It was a real pleasure to learn from you.

Dr. Zainab Okolo, LCMFT
Thank you so much, Van. Glad to be here.

Van Ton-Quinlivan
I’m Van Ton-Quinlivan with Futuro Health. Thanks for checking out this episode of WorkforceRx. I hope you will join us again as we continue to explore how to create a future focused workforce in the nation.